abstrak - Repository Maranatha - Universitas Kristen Maranatha
advertisement
ABSTRAK HUBUNGAN PENGETAHUAN, SIKAP, DAN PERILAKU KELOMPOK RISIKO TINGGI TENTANG HIV-AIDS DI KOTA BANDUNG PERIODE TAHUN 2014 Mia Maya Ulpha, 2014. Pembimbing I : Penny S. Martioso, dr., SpPK, M.Kes Pembimbing II : Ronald Jonathan, dr., M.Sc., DTM & H Infeksi Human Immunodeficiency Virus (HIV) telah berkembang menjadi masalah kesehatan dunia. Infeksi HIV bila tidak terdiagnosis dan mendapatkan penanganan dapat asimptomatik dan berkembang menjadi Acquired Immune Deficiency Syndrome (AIDS). AIDS adalah penyakit berbahaya yang melemahkan sistem kekebalan tubuh dan berakhir dengan kematian. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan, sikap, dan perilaku kelompok wanita penjaja seksual (WPS) yaitu salah satu kelompok risiko tinggi infeksi HIV-AIDS. Penelitian survei analitik ini dengan cross sectional design dan convenience sampling terhadap kelompok WPS beberapa lokalisasi di Kota Bandung pada periode Agustus-September 2014. Data disajikan dengan tabel distribusi dan dianalisis dengan Chi Square untuk mengetahui apakah terdapat hubungan antara pengetahuan, sikap, dan perilaku. Tentang infeksi HIV-AIDS, 63,15% responden memiliki pengetahuan cukup, sikap 78,94% responden dan perilaku 97,36% responden adalah baik. Hasil analisis statistik terbukti adanya hubungan signifikan antara pengetahuan dengan sikap (p-value 0,043, p <0,05), dan adanya hubungan yang sangat signifikan antara pengetahuan dengan perilaku (p-value 0,008, p ≦0,01) dan hubungan antara sikap dengan perilaku (p-value 0,000, p ≦ 0,01). Pengetahuan tentang infeksi HIV-AIDS kelompok WPS Kota Bandung periode Agustus-September 2014 cukup, serta memiliki sikap dan perilaku baik tentang infeksi HIV-AIDS. Terdapat hubungan signifikan antara pengetahuan dengan sikap, dan terdapat hubungan yang sangat signifikan antara pengetahuan dengan perilaku serta hubungan antara sikap dengan perilaku. Kata kunci: pengetahuan, sikap, perilaku, HIV-AIDS iv Universitas Kristen Maranatha ABSTRACT Relations Between Knowledge, Attitude, and Behavior Towards HIV-AIDS Infections In High Risk Group in Bandung period of 2014 Mia Maya Ulpha, 2014 ; 1st Tutor : Penny Setyawati Martioso, dr., SpPK, M.Kes 2nd Tutor : Ronald Jonathan, dr., M.Sc., DTM & H Human Immunodeficiency Virus have become a global health problem, the infection if left undiagnosed, can become asymptomatic, and progressed into Acquired Immuno Deficiency Syndrome or AIDS. AIDS is a lethal disease that weakens the immune system, and may eventually leads to death. This study aims to find the relations between knowledge, attitude and behavioural on Female Sex Worker (FSW), which is one of the high risk group of contracting HIV-AIDS. This was an analytical survey, with cross sectional design and convenience sampling on Female Sex Worker on few brothels in Bandung city, in the period of August through September 2014, the data was presented with distribution tabels, and was analyzed with Chi Square, to find out whether there were relations between knowledge, attitude and behaviour. On HIV-AIDS infection, 63.15% of the responders have sufficient knowledge, 78.94% of the respondens have good attitude and 97.36% of the respondens have good behavior. The result of statistical analysis had shown that there were significant differences in relation between knowledge with attitude p=0.043(p<0.05). While very significant result in relation of knowledge with behavior p=0.008 (p≦0.01) and also in attitude with behavior p=0.000 (p≦0.01). The study finds that the knowledge of HIV-AIDS on FSW in the city of Bandung of the period August-September 2014 is sufficient, and had good attitude and behavior on the HIV-AIDS. There were significant differences in relation between knowledge with attitude. While very significant result in relation of knowledge with behavior and also in attitude with behavior. Keyword : knowledge, attitude, behavior, HIV-AIDS v Universitas Kristen Maranatha DAFTAR ISI JUDUL ......................................................................................................................... i LEMBAR PERSETUJUAN ...................................................................................... ii SURAT PERNYATAAN .......................................................................................... iii ABSTRAK ................................................................................................................. iv ABSTRACT ................................................................................................................. v KATA PENGANTAR ............................................................................................... vi DAFTAR ISI ............................................................................................................ viii DAFTAR TABEL..................................................................................................... xii DAFTAR GAMBAR ............................................................................................... xvi DAFTAR LAMPIRAN .......................................................................................... xvii BAB I PENDAHULUAN 1.1 Latar Belakang ................................................................................................. 1 1.2 Identifikasi Masalah ......................................................................................... 2 1.3 Maksud dan Tujuan Penelitian ......................................................................... 3 1.3.1 Maksud Penelitian .................................................................................... 3 1.3.2 Tujuan Penelitian ..................................................................................... 3 1.4 Manfaat Karya Tulis Ilmiah ............................................................................. 3 1.4.1 Manfaat Akademis ................................................................................... 4 1.4.2 Manfaat Praktis ........................................................................................ 4 1.5 Kerangka Pemikiran .......................................................................................... 4 1.6 Hipotesis ............................................................................................................ 5 BAB II TINJAUAN PUSTAKA 2.1 Domain Perilaku ............................................................................................... 6 2.1.1 Domain Kognitif ...................................................................................... 6 2.1.2 Domain Afektif ........................................................................................ 9 viii Universitas Kristen Maranatha 2.1.3 Domain Psikomotor ............................................................................... 10 2.2 Perilaku Kesehatan .......................................................................................... 11 2.2.1 Perilaku Pemeliharaan Kesehatan .......................................................... 11 2.2.2 Peilaku Pencarian & Penggunaan/Sistem Pelayanan ............................. 12 2.2.3 Perilaku Kesehatan Lingkungan ............................................................ 12 2.3 Determinan Perilaku Manusia ......................................................................... 13 2.4 Infeksi Menular Seksual .................................................................................. 16 2.5 Human Immunodeficiency Virus (HIV) .......................................................... 21 2.5.1 Definisi HIV ........................................................................................... 21 2.5.2 Definisi AIDS......................................................................................... 21 2.5.3 Struktur HIV........................................................................................... 22 2.5.4 Siklus Replikasi HIV.............................................................................. 22 2.5.5 Epidemiologi HIV .................................................................................. 25 2.5.6 Faktor Risiko HIV .................................................................................. 26 2.5.7 Klasifikasi HIV ...................................................................................... 27 2.5.8 Uji Saring HIV ....................................................................................... 29 2.6 Program Pencegahan Penularan HIV-AIDS Bagi Kabupaten/Kota .............. 33 2.6.1 Kegiatan Promosi Pencegahan Pennularan HIV-AIDS dan IMS .......... 33 2.6.2 Mengaktifkan Klinik IMS ...................................................................... 35 2.6.3 Pembentukan Klinik PPIA................... .................................................. 35 2.7 Intervensi Perubahan Perilaku ........................................................................ 36 2.7.1 Intervensi Terarah dalam Menaggulangi Transmisi HIV&IMS ............ 36 2.7.2 Model Intervensi Klinis Dengan Pengobatan Presumtif ........................ 37 2.8 Materi KIE ...................................................................................................... 38 2.8.1 Menjelaskan Pilihan Perilaku Seksual Aman ........................................ 38 2.8.2 Mengenali Hambatam Dalam Mengubah Perilaku Seksual Berisiko .... 39 2.8.3 Kepentingan Mengobati Pasangan Seksual ........................................... 39 ix Universitas Kristen Maranatha 2.8.4 Manfaat Kondom ................................................................................. 40 2.9 Penelitian PSP Tentang HIV-AIDS Di Indonesia …………………. ........ 41 BAB III BAHAN DAN METODE PENELITIAN 3.1Instrumen/Subjek Penelitian ............................................................................ 48 3.1.1 Instrumen Penelitian............................................................................... 48 3.1.2 Subjek Penelitian.................................................................................... 48 3.2 Tempat dan Waktu Penelitian ......................................................................... 48 3.2.1 Tempat Penelitian................................................................................... 48 3.2.2 Waktu Penelitian .................................................................................... 48 3.3 Metode Penelitian............................................................................................ 49 3.3.1 Variabel Penelitian ................................................................................. 49 3.3.2 Definisi Operasional Variabel ................................................................ 49 3.3.3 Besar Sampel dan Teknik Pengambilan Sampel Penelitian .................. 49 3.3.4 Prosedur Penelitian................................................................................. 50 3.4 Metode Analisis Data ..................................................................................... 50 3.4.1 Pengetahuan ........................................................................................... 50 3.4.2 Sikap....................................................................................................... 51 3.4.3 Perilaku .................................................................................................. 52 3.5 Aspek Etik Penelitian ..................................................................................... 53 BAB IV HASIL DAN PEMBAHASAN 4.1 Karakteristik Responden ................................................................................. 54 4.2 Pengetahuan .................................................................................................... 64 4.3 Sikap................................................................................................................ 79 4.4 Perilaku ........................................................................................................... 90 4.5 Pengetahuan Responden Secara Keseluruhan ................................................. 98 4.6 Sikap Responden Secara Keseluruhan .......................................................... 101 4.7 Hubungan PSP Responden Tentang Infeksi HIV-AIDS ............................... 104 4.7.1 Hubungan Antara Pengetahuan dengan Sikap ..................................... 104 4.7.2 Hubungan Antara pengetahuan dengan Perilaku ................................. 105 4.7.3 Hubungan Antara Sikap dengan Perilaku ............................................ 106 x Universitas Kristen Maranatha BAB V SIMPULAN DAN SARAN 5.1 Simpulan ....................................................................................................... 107 5.2 Saran.............................................................................................................. 107 DAFTAR PUSTAKA ............................................................................................ 109 LAMPIRAN ............................................................................................................ 111 RIWAYAT HIDUP ................................................................................................ 120 xi Universitas Kristen Maranatha DAFTAR TABEL Tabel 2.1 Infeksi Menular Seksual............................................................................. 17 Tabel 3.1 Definisi Operasional .................................................................................. 49 Tabel 4.1 Distribusi Usia Responden ......................................................................... 54 Tabel 4.2 Distribusi Asal Daerah Responden ............................................................ 55 Tabel 4.3 Distribusi Tingkat Pendidikan Responden ................................................. 56 Tabel 4.4 Distribusi Status Perkawinan Responden .................................................. 57 Tabel 4.5 Distribusi Jumlah Anak Responden ........................................................... 58 Tabel 4.6 Distribusi Umur Pertama Kali Responden Melakukan Hubungan Seks.... 58 Tabel 4.7 Distribusi Alasan Responden Memilih Pekerjaan Sebagai WPS............... 59 Tabel 4.8 Distribusi Lama Kerja Responden Di Tempat Bekerja ............................. 60 Tabel 4.9 Distribusi Pekerjaan Terakhir Responden.................................................. 60 Tabel 4.10 Distribusi Rata-Rata Tamu Responden dalam Sehari .............................. 61 Tabel 4.11 Distribusi Apakah Responden Mempunyai Pelanggan Tetap .................. 62 Tabel 4.12 Distribusi Jumlah Pelanggan Tetap Responden ....................................... 62 Tabel 4.13 Distribusi Media KIE yang Di Butuhkan Responden .............................. 63 Tabel 4.14 Distribusi Sumber Pengetahuan Kesehatan Responden........................... 63 Tabel 4.15 Distribusi Pengetahuan Penyakit Infeksi Menular Seksual (IMS) Responden ................................................................................................. 64 Tabel 4.16 Distribusi Pengetahuan Gejala Orang yang Terkena Penyakit Infeksi Menular Seksual (IMS) Responden ........................................................... 65 Tabel 4.17 Distribusi Pengetahuan Cara Penularan Penyakit Infeksi Menular Seksual Responden .................................................................................... 66 Tabel 4.18 Distribusi Pengetahuan Cara Pencegahan Penyakit Infeksi Menular Seksual Responden .................................................................................... 68 Tabel 4.19 Distribusi Pengetahuan HIV Responden................................................. 69 Tabel 4.20 Distribusi Pengetahuan Responden Mengenai Cara Penularan HIV ....... 69 xii Universitas Kristen Maranatha Tabel 4.21 Distribusi Pengetahuan Kegiatan yang Tidak Menularkan HIV Responden ................................................................................................. 71 Tabel 4.22 Distribusi Pengetahuan Gejala Orang yang Terinfeksi HIV Responden . 72 Tabel 4.23 Distribusi Pengetahuan Cara Pencegahan HIV Responden ..................... 73 Tabel 4.24 Distribusi Pengetahuan Responden Mengenai Perbedaan Antara HIV dan AIDS ................................................................................................... 74 Tabel 4.25 Distribusi Pengetahuan Tanda Orang yang Sudah Menjadi AIDS Responden ................................................................................................. 75 Tabel 4.26 Distribusi Pengetahuan Cara Mengetahui Status HIV Responden .......... 76 Tabel 4.27 Distribusi Pengetahuan Fungsi Kondom Responden ............................... 77 Tabel 4.28 Distribusi Pengetahuan Cara yang Benar Memakai Kondom Responden ................................................................................................. 78 Tabel 4.29 Distribusi Sikap Responden Mengenai Kegiatan Penyuluhan Kesehatan Sangat Bagus Untuk Diadakan ................................................ 79 Tabel 4.30 Distribusi Sikap Responden Mengenai Kekhawatiran Tertular IMS atau HIV Karena Pekerjaanya ................................................................... 80 Tabel 4.31 Distribusi Sikap Responden Mengenai Sebaiknya Mengetahui Gejala dan Cara Pencegahan IMS atau HIV ......................................................... 80 Tabel 4.32 Distribusi Sikap Responden Mengenai Harus Lebih Berhati-hati Terhadap IMS atau HIV Karena Tidak Selalu Dirasakan Gejalanya ........ 81 Tabel 4.33 Distribusi Sikap Responden Mengenai Mengkonsumsi Antibiotik Tidak Dapat Mencegah Tertular IMS atau HIV ........................................ 82 Tabel 4.34 Distribusi Sikap Responden Mengenai IMS atau HIV Merupakan Penyakit yang Berbahaya .......................................................................... 82 Tabel 4.35 Distribusi Sikap Responden Mengenai Dampak Bila Terkena IMS atau HIV Pada Pekerjaan dan Kehidupanya ..................................................... 83 Tabel 4.36 Distribusi Sikap Responden Pernah Membaca Informasi Tentang IMS atau HIV Secara Benar ............................................................................. 83 Tabel 4.37 Distribusi Sikap Responden Mengenai Harus Melalukan Pemeriksaan Rutin Ke Dokter Karena Pengunaan Kondom Klien Belum Konsisten .... 84 xiii Universitas Kristen Maranatha Tabel 4.38 Distribusi Sikap Responden Mengenai Papi atau Mami Menyarankan Untuk Pergi Ke Dokter .............................................................................. 84 Tabel 4.39 Distribusi Sikap Responden Mengenai Teman Selalu Mengingatkan Untuk Memakai Kondom .......................................................................... 85 Tabel 4.40 Distribusi Sikap Responden Mengenai Penggunaan Kondom Itu Penting.. ..................................................................................................... 86 Tabel 4.41Distribusi Sikap Responden Mengenai Setuju Dengan Penjualan Kondom Ditempat ..................................................................................... 86 Tabel 4.42 Distribusi Sikap Responden Mengenai Kepedulian Terhadap Tamu Untuk Memakai Kondom .......................................................................... 87 Tabel 4.43 Distribusi Sikap Responden Mengenai Pemakaian Kondom Setelah Membaca Informasi Mengenai Bahaya Terinfeksi IMS atau HIV............ 88 Tabel 4.44 Distribusi Sikap Responden Mengenai Kesediaanya Menjadi PE........... 89 Tabel 4.45 Distribusi Sikap Responden Mengenai Kepedulian Terhadap Kesehatan Dirinya ..................................................................................... 89 Tabel 4.46 Distribusi Perilaku Apa yang Dilakukan Jika Mengalami Gejala IMS Responden ................................................................................................. 90 Tabel 4.47 Distribusi Perilaku Responden Mengenai Jika Menemui Teman yang Mempunyai Gejala IMS ............................................................................ 91 Tabel 4.48 Distribusi Perilaku Pernah Melalukan Kegiatan yang Dilaksanakan RT/RW Responden .................................................................................... 91 Tabel 4.49 Distribusi Perilaku Rutin Memeriksakan Diri Ke Dokter Responden ..... 92 Tabel 4.50 Distribusi Perilaku Rutin Memeriksakan Diri Walaupun Tidak Ada Keluhan Responden ................................................................................... 93 Tabel 4.51 Distribusi Perilaku Menawarkan Kondom Kepada Tamu Responden .... 94 Tabel 4.52 Distribusi Perilaku Pengunaan Kondom Saat Hubungan Seks Terakhir Responden ................................................................................................. 95 Tabel 4.53 Distribusi Perilaku Jumlah Tamu Dalam Satu Minggu Responden ........ 95 Tabel 4.54 Distribusi Perilaku Pemakaian Kondom Pada Tamu Responden ............ 96 Tabel 4.55 Distribusi Perilaku Melakukan Tes HIV Responden ............................... 97 Tabel 4.56 Distribusi Siapa yang Meminta Responden Melakukan Tes HIV ........... 98 xiv Universitas Kristen Maranatha Tabel 4.57 Distribusi Motivasi Melakukan Tes HIV ................................................. 98 Tabel 4.58 Distribusi Pengetahuan Responden Secara Keseluruhan ......................... 99 Tabel 4.59 Distribusi Sikap Responden Secara Keseluruhan .................................. 101 Tabel 4.60 Distribusi Perilaku Responden Secara Keseluruhan .............................. 102 Tabel 4.61 Hubungan Antara Pengetahuan dengan Sikap ....................................... 104 Tabel 4.61 Hubungan Antara Pengetahuan dengan Perilaku ................................... 105 Tabel 4.63 Hubungan Antara Sikap dengan Perilaku .............................................. 106 xv Universitas Kristen Maranatha DAFTAR GAMBAR Gambar 2.1 Struktur virion HIV ............................................................................... 22 Gambar 2.2 Proses replikasi HIV.............................................................................. 25 Gambar 2.3 Konseling & Tes HIV ........................................................................... 29 Gambar 2.4 Alogaritma pemeriksaan skrining HIV .................................................. 30 xvi Universitas Kristen Maranatha DAFTAR LAMPIRAN Lampiran 1Kuisioner Penelitian .............................................................................. 111 Lampiran 2 Surat Keterangan Penelitian ................................................................. 117 Lampiran 3 Informed Consent ................................................................................. 118 Lampiran 4 Surat Keputusan Komisi Etik Penelitian .............................................. 119 xvii Universitas Kristen Maranatha